胎儿外科与整形外科

由于对胎儿的检测技术的进步,对某些非致命性胎儿疾胎儿外科处理是可能的。当然,对大多数诊断有先天畸形的胎儿,最好在出生后再作治疗。但是某些病例可以选择性地在胎儿期间进行手术。本文就是介绍胎儿外科目前在实验与临床方面的进展。     

胸心外科技术向微创和复杂两极化发展

20世纪40年代至今是人类历史上科技发展最为迅猛的时期,胸心血管外科经过了半个多世纪的历程,已经取得了巨大的成就,传统理念上的外科技术已十分成熟。随着人口老龄化的出现、疾病谱的变化和人们对健康要求的不断提高,对胸心外科的技术发展提出了更高的要求。科技的进步使新型诊治手段不断涌现,传统禁忌不断被突破,复杂高危手术中微创技术的应用成为可能。胸心外科必将会沿着微创和“巨创”的两极化方向发展。     

机器人辅助外科手术系统在肝胆胰外科中的应用

随着机械力学、计算机学、远程数据分析技术等科技水平的不断提高,用于外科手术的机器人研究及其临床应用方兴未艾,多年来逐渐形成以达芬奇手术系统(Da Vinci surgical system)和宙斯遥控机器人手术装置(ZEUS system)为主体的手术机器人临床应用装置.     

机器人外科手术系统在心脏外科中的应用

目前,在达芬奇机器人外科手术系统辅助下可进行的心脏手术包括冠状动脉旁路移植术、二尖瓣成形和置换术、先天性心脏病纠治术、心房颤动消融术、起搏导线植入术、心内肿瘤切除术等,本文就其现状和发展作一介绍.     

鼻内镜鼻窦、鼻中隔、鼻甲联合手术87例

目的:探讨鼻窦、鼻中隔、鼻甲联合手术对慢性鼻窦炎合并鼻中隔偏曲的治疗效果。方法:按是否矫正鼻中隔分为2组,A组65例采用Messerkinger术式开放鼻窦,修整中鼻甲,外移和修整下鼻甲;B组87例先行保留方形软骨的鼻中隔矫正术,再行Messerkinger术式开放鼻窦,修整中鼻甲,外移和修整下鼻甲。随访6～12月。判定疗效。结果:A组:治愈39例(60.0%),好转13例(20.0%),无效13例(20.0%),总有效率80.0%;B组:治愈67例(77.0%),好转14例(16.1%),无效6例(6.9%),总有效率93.1%。两组比较总有效率差异有显著性(P<0.05)。结论:鼻窦、鼻中隔、鼻甲联合手术治疗慢性鼻窦炎合并鼻中隔偏曲,疗效优于单纯鼻窦、鼻甲手术,并且安全可靠。     

单孔腹腔镜技术在普通外科的应用

单孔腹腔镜技术是在传统多孔腹腔镜技术上发展起来的一门新兴技术。单孔腹腔镜技术已在普通外科各领域大量应用,以其更小的创伤、卓越的美容效果和广阔的发展前景,引起了广泛的关注,在国内外均有大量的报道。现就国内外单孔腔镜普通外科手术开展现状、发展过程、手术难点、应用前景进行阐述。     

改良Miccoli术式切口变通在甲状腺术中的应用

1临床资料1．1一般资料选择2007年4月至2009年6月我院接受改良Miccoli术式的180例甲状腺肿瘤,其中83例行改良Miccoli术式,采用了切口变通切除甲状腺肿瘤,女81例,男2例;年龄23～65岁。40例为左侧甲状腺肿块,31例为右侧,12例双侧。既往均无甲状腺手术史。     

机器人外科手术系统在普胸外科中的应用

目前,全球已有1 750多台机器人外科手术系统服务于临床,早期主要用于心脏外科、泌尿外科,近年来也广泛用于普胸外科、普外科、妇科,在普胸外科手术中,主要用于肺外科切除及肺癌淋巴结清扫、食管外科、纵隔肿瘤切除等.     

Plastic surgery

Cinicai study of surgical treatment of ankylosis of temporomandibular joint;Protective effects of nuclear factor-kB inhibitor on ischemia-reperfusion island myocutaneous flaps in pigs;Expression of agrin gene in the primary culture of skeletal myoblasts; Differentially expressed proteins of hypertrophic scar epidermal cells;Modified transcranial orbitotomy for treating exophthalmic intraorbital tumor; Expression and significance of Skp2 and p27^ktp1 protein in pathological scar;……     

Plastic surgery

206657Applied anatomy of the neurovascular distribu-tion in extensor carpi ulnaris/Chen Gang(陈刚,DeptPlast Surg, Changzheng Hosp, 2nd Mil Med Univ,Shanghai 200003)…∥ChinJ Microsurg.-2006 ,29(4) .-271 ~273ObjectiveTo observe the intramuscular neurovas-cular distribution in extensor carpi ulnaris and evaluatewhether the muscle conld besplitintoseveral functional u-nits in transplantation.MethodsTwenty formaldehyde-fixed extensor carpi ulnaris in ten cadavers were used inthe study for ob…     

Vascular surgery

<正>209189 Experience of endovenous radiofrequency combined with TriVex in treatment of chronic venous insufficiency in lower extremity/Lin Shaomang(Dept Vascul Surg,2nd Affil Hosp,Guangzhou Med Col,Guangzhou 510260)…∥Chin J Surg.-2009,47(4).-271~274Objective To evaluate therapeutic results of endovenous radiofrequency in combination with TriVex in treatment of venous insufficiency in lower extremities.Methods One hundred and fifty patients with chronic venous insufficiency(150 limbs) were randomly assigned to Group A(75 limbs) and Group B(75 limbs).Patients in Group A were treated with long saphenous veins radiofrequency ablation procedures in combination with TriVex.Patients in Group B were treated with long saphenous veins traditional stripping operation in combination with TriVex.The postoperative pain,average hospital stay and short-term results in hospital were compared between the two groups.Self-assessment of the opertion 4 weeks later,changes of CEAP classification,venous clinical severity score(VCSS) and chronic venous insufficiency questionnaire(CIVIQ) score were compared between the two groups.Results The operation time in Group A was (67±11) min,compared with (59±9) min in Group B(P>0.05).Postoperative pain and average hospital stay in Group A was higher than that in Group B 4 weeks after operation(P<0.05).The change of CEAP classification,VCSS and quality of life were signifcant after operation in both groups.The VCSS of Group A decreased by 4.6±2.5 compared with 4.3±2.7 in Group B (P>0.05).Conclusion Endovenous radiofrequency combined with TriVex for treatment of venous insufficiency in lower extremity is available,effective and with less trauma and faster recovery.CEAP classification,VCSS and CIVIQ are useful tools for assessing outcomes after radiofrequency in these patients.10 refs,4 tabs.